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How would you consider your initial impression to the landscape and surrounding prior to entering the branch?
 
Very poor
 
Somewhat unsatisfactory
 
About average
 
Very satisfactory
 
Excellent
 
 
 
Would you please take a few minutes to describe what about the location or surroundings stands out:
   
 
 
 
The branch allowed for a comfortable and professional setting:
 
Strongly disagree
 
Somewhat disagree
 
Neutral
 
Somewhat agree
 
Strongly agree
 
Further comments
 

 
 
 
What was your initial impression of the sales representative(s) greeting and appearance?
 
Very poor
 
Somewhat unsatisfactory
 
About average
 
Very satisfactory
 
Excellent
 
 
 
Would you please take a few minutes to describe what about representative stands out:
   
 
 
 
Was the customer service representative aware of what was important in serving the customer?
 
Very aware at the first attempt
 
Aware, but only after some research or further questioning
 
Somewhat aware
 
Not aware, but able to ask another representative who was
 
Not at all aware
 
Other
 
 
 
 
Was the representative alert to the sales opportunities and were the products presented in an orderly and neat manner?
 
The representative was knowledgeable on all prompted opportunities and products
 
The representative introduced me to new products more beneficial to my needs
 
The representative was not completely knowledgeable but used other resources to assist and become more familiar with the promotion
 
The representative knew the promotions presented but offered little or no advice on other promotions
 
The representative knew little or nothing about any of the promotions mentioned
 
Other
 

 
 
 
The customer service representative handled my questions/concerns/interests in a timely fashion
 
Strongly disagree
 
Somewhat disagree
 
Neutral
 
Somewhat agree
 
Strongly agree
 
Further Comments
 

 
 
 
Was there anything about the courteousness of the service that stands out as being superior?
 
Patient
 
Enthusiastic
 
Listened carefully
 
Friendly
 
Responsive
 
Other
 

 
 
 
What about the representative could be improved?
 
Not patient
 
Not enthusiastic
 
Didn't listen carefully
 
Unfriendly
 
Unresponsive
 
No improvement needed
 
Other
 
 
 
 
If a problem occured, what would best describe what happened?
 
Kept me waiting on hold
 
Had to explain several times
 
Didn't know how to handle the problem
 
Had to ask others
 
Spoke too slowly
 
Spoke too quickly
 
They didn't understand the question
 
Gave unclear answers
 
Couldn't solve problem
 
Disorganized
 
Other
 

 
 
 
Did the customer service representative(s):
 
Identify themselves
 
Initiate friendly conversation
 
Maintain eye contact
 
Smile
 
Say Please/Thank You
 
Seek your name
 
Invite you to be seated
 
Ask if you are a current customer
 
Use your name free in conversation
 
Respond/Listen appropriately
 
Clearly explain the products and promotions
 
Seek to find answers to questions
 
Observe customer confidentiality
 
Provide business card or other means of communication
 
 
Further Comments
 

 
 
 
Did the customer service representative illustrate any of the following acts:
 
Trust
 
Tact
 
Empathy
 
Conformity
 
Focus
 
Flexibility
 
Other
 

 
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